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What Happened to the Time? The Relationship of Occupational Therapy to Time

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Abstract

Introduction Time has a reciprocal relationship with occupation: each helps to define and give meaning to the other. This paper explores how this interconnection has been embraced within occupational therapy. Method Literature from a variety of disciplines was critically reviewed, in order to discern how occupational therapy has engaged with the temporal dimensions of occupation since its inception and the relevance of time to current practice. Findings and discussion Although theoretical discussions demonstrate the importance of aspects of time within occupation, there has been only limited translation of these into occupational therapy practice. Aspects of time use, tempo and temporality are discussed in relation to their application to clinical practice. As the pace of life increases and humanity's relationship with time changes, this presents the profession with both challenges and opportunities. Conclusion Time is a vital aspect of occupation. Occupational therapists need to return to core values of time awareness, rhythm and balance, because the profession once again needs to find time.

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... Studies which examined various populations demonstrating difficulties related to time organization also reported problems engaging in significant activities and daily life routines (Pemberton and Cox, 2011;. Additionally, a review of occupational therapy studies indicated the need for quantitative research concerning time organization among healthy populations in different life contexts (Hunt and McKay, 2015). ...
... Time-organization ability is essential for effective, independent engagement in the activities comprising one's life routine (Kielhofner, 2002;Pemberton and Cox, 2011). Organization, defined as an executive function, constitutes part of the meta-cognitive skills, referring to people's ability to sort their thoughts on a proper continuum of work stages and coordinated timing (Katz and Hartmann-Maeir, 2005). ...
... Only one significant relationship was found between time-organization ability (TOPS B) and participants' motivation level. These findings demonstrated the positive relationship portrayed in the literature between time-organization ability and general levels of participation and feelings of enjoyment and motivation (Pemberton and Cox, 2011). They reinforced the understanding that the way in which individuals organize their time in relation to the occupation in which they choose to participate significantly affects their ability to be involved in the fabric of life (level of performance) and satisfaction (level of enjoyment) and, accordingly, quality of life (Fricke and Unsworth, 2001). ...
Article
Introduction In today's academic world, higher education students from all study areas are expected to simultaneously cope with a variety of assignments, which increases stress levels. This tension may affect productivity, health and quality of life. Hence, it is important for students to adopt effective time organization and management techniques. This study aims to characterize time organization and participation dimensions, and the relationships between those dimensions among undergraduate students. Method The research sample consisted of 60 undergraduate students who completed several questionnaires: demographic, time organization and participation scales assessing daily time organization; an occupational questionnaire; and additional questions for assessing further daily participation dimensions that are unique to students. Results Time-organization ability related to and maintained a predictive relationship with individual daily participation aspects. Particularly, academic and daily routine constituted a majority (44%) of the students' time. Regression analysis indicated that the way the students' daily activities were organized in terms of time use explained between 12% and 18% of the variance of daily participation dimensions as performance, enjoyment and motivation levels. Conclusion Time-organization abilities significantly affected students' participation dimensions. Further research is recommended to help develop an assessment and intervention programme suiting student needs and enhancing their productivity potential and wellbeing.
... Concepts such as life balance (Sheldon, 2009) and occupational balance (Wagman, Hakansson, & Bjorklund, 2012), however, have focused primarily on the measureable distribution of time or time use. Although there have been studies on aspects of time use in relation to specific health problems (Lynch, 2009;McKenna, Broome, & Liddle, 2007;Stewart & Craik, 2007) there has been less consideration of how aspects such as tempo and temporality influence the experience of occupation (Pemberton & Cox, 2011). As occupational therapists, specialising in the condition of chronic fatigue syndrome/ myalgic encephalomyelitis (CFS/ME), we were interested in how people talked about time within the context of this chronic health condition, and the perception of time as a barrier to improving occupational balance. ...
... Yet whilst the concept of pacing is frequently described in relation to restriction or limitation of action, contingent on time length or symptom level, aspects of speed and tempo are often not considered. This is a reflection of the focus on activity performance without connectivity to its temporal dimensions (Pemberton & Cox, 2011). Therefore, while research has promoted the role of rehabilitation programmes for CFS/ME (Cox, 1999Cox, , 2002Pemberton, Hatcher, Stanley, & House, 1994;S U S A N P E M B E RT O N & D I A N E C O XTaylor, 2004), understanding the importance of temporal elements of occupation within the condition and recovery process could inform the way in which occupations are paced, balanced, modified and graded as an intervention. ...
... This is a reflection of the focus on activity performance without connectivity to its temporal dimensions (Pemberton & Cox, 2011). Therefore, while research has promoted the role of rehabilitation programmes for CFS/ME (Cox, 1999Cox, , 2002Pemberton, Hatcher, Stanley, & House, 1994;S U S A N P E M B E RT O N & D I A N E C O XTaylor, 2004), understanding the importance of temporal elements of occupation within the condition and recovery process could inform the way in which occupations are paced, balanced, modified and graded as an intervention. The current study sought to explore the personal experience of time, tempo and temporality within CFS/ME and its relationship to perceived patterns of activity both before and through experiencing the condition. ...
Article
Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is a disabling condition that disrupts the normal rhythms and activity patterns of daily life. Although temporal dimensions such as time use, tempo and temporality have an important relationship to occupation there has been limited study of these factors within CFS/ME. This qualitative study explored how people with CFS/ME perceived the relationship between time and occupation through the experience of their illness. A social constructivist approach to grounded theory involving in-depth interviews with 14 participants, recruited through a specialist service in the UK, revealed emerging concepts of accelerating time before illness, with a focus on imminent tasks. During illness actions slowed, but contrasted with the experience for some participants of time disappearing. As participants adjusted to the condition there was a greater focus on being present and consciously slow, as a sense of control within time emerged. These findings suggest that further consideration is given to the broader aspects of time and rhythm within occupational science, evolving from the current clock time perspective to incorporate event time and resynchronisation of occupational balance.
... When the concept of time is used it may include people, placements and the context of a past, present or the future (Pemberton & Cox, 2011). The activities of all people are performed in contexts in relation to time and have a relationship to health, as illustrated in occupational therapy theories (Hunt & McKay, 2015a). ...
... The activities of all people are performed in contexts in relation to time and have a relationship to health, as illustrated in occupational therapy theories (Hunt & McKay, 2015a). There is a connectivity between doing, being, rhythm and balance and time is a vital aspect of occupation (Pemberton & Cox, 2011). Peloquin (1991) regards the connection between time and occupation in OT as fundamental; ...
... Time is a component of patterns of daily occupations and occupational balance, which are recurring phenomena in occupational science (Eklund et al., 2017). Time has a reciprocal relationship with occupation, with each helping to define and give meaning to the other (Pemberton & Cox, 2011). Examining the temporal structure of daily occupational patterns, meaning what people do with their time (time-use), provides an objective view, while occupational balance, which refers to the optimal variation between occupations, provides a subjective view (Eklund et al., 2010(Eklund et al., , 2017. ...
Article
People all over the world have needed to adapt to social distancing, movement restrictions, and change in life routines due to Coronavirus disease 19 (COVID-19). This study aimed to explore the relationships between time-use, occupational balance, and temporal life satisfaction of university students in Turkey during the social isolation period due to the COVID-19 pandemic. The study was conducted online in May 2020, with 128 university students of a Turkish university with the mean age of 20.27 ± 1.49 years (Min. 18 - Max. 26 years old) from 37 cities. The measures used were the Occupational Balance Questionnaire (OBQ), the Temporal Satisfaction with Life Scale (TSWLS), and a customized question about the time-use of the students in specific occupational domains. The results indicated that individuals with lower occupational balance had less present life satisfaction (p < .001). While the time allocated to study lessons, socialization, and exercise had small positive correlations with OBQ (p <.01), watching TV had a negative correlation with OBQ (p <.05) and with ‘present TSWLS’ (p <.01). The mean value of ‘present TSWLS’ (15.45 ± 7.54) was lower than ‘past TSWLS’ (21.57 ± 6.27) and ‘future TSWLS’ (22.64 ± 4.60). Evaluation of occupational balance and the time use patterns of university students during the isolation periods could be important due to its relationship with life satisfaction. This issue raises the potential need for preventive occupation-based interventions to address the mental health of the community.
... The temporal dimension in this study also included the use of time as a commodity. This notion of time as a commodity has been a focus of discussion in the literature [65,66] where time is measured and valued against a clock and termed "clock time". It was important to the participants of our study to fill their time with activities, and importantly, when participants' time was filled, their need for action was met, highlighting the dynamic nature of the relationship outlined in the figure between the Personal Dimension and the Temporal Dimension. ...
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Purpose To investigate stroke survivors’ activity participation 3-months after stroke, reasons for activity participation and the change in reason for activity participation. Method Thirty stroke survivors were administered the Activity Card Sort-Australia concurrent with a semi-structured interview about their activity participation. Data were analyzed using descriptive statistics and spiral content analysis. Results Participants had returned, in part, to 96% of their previous leisure, social/educational and household activities 3-months after-stroke; retaining more sedentary and home-based activities but fewer physically demanding and community-based activities. Thirteen participants described a change in their reasons for their activity participation. Personal, environmental and temporal dimensions explained these reasons for activity participation, as well as the changes in reason for activity participation. Full activity participation involved participants’ orchestrating a dynamic mix of fulfilling their personal desires according to their current physical, mental and emotional capacity; their social, organizational and physical environmental demands and obligations; and their routines, available time and future plans. Conclusion Qualitative interviews extend our understanding of the process of returning to participation in life activities and occupations following stroke to reveal that it involves the stroke survivor in a dynamic adaptation process of synchronizing personal, environmental and temporal dimensions in their daily lives. • IMPLICATIONS FOR REHABILITATION • Rehabilitation professionals need to recognize the unique knowledge and ability stroke survivors have to manage their capacities, activities, occupations and environments. • Client-centered practice involving true collaborative partnerships are needed to ensure stroke survivors return more satisfactorily to their activities and occupations. • Rehabilitation professionals need to continually consider the ongoing changing relationships that occur between the person, their capacities, social, organizational and physical environments, and the person’s activity/occupational participation during recovery from stroke. • Returning to full activity/occupational participation after stroke is a dynamic and continuous process. • Rehabilitation needs to be provided in different forms at different stages beyond the immediate post-stroke time so that stroke survivors benefit from the “right rehabilitation” at the “right time” throughout their recovery journey.
... Effective utilization of time has been found to be associated with health and wellbeing, which are thus interpreted together in the literature (Wilcock, 2014). Engagement in meaningful occupations that have been structured to achieve satisfying daily activities will enhance wellbeing (Hammell and Iwama, 2012), although further knowledge is needed to develop an understanding of how temporal structures of occupations will influence health (Pemberton and Cox, 2011;Yerxa, 2014). ...
Article
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Introduction The understanding of the temporal pattern of individuals can add a wider perspective to interventions. Therefore, the present study is aimed toward analysis of the temporal activity pattern of individuals with stroke compared to healthy adults. Method This study is a prospective, case–control, analytic research study. The study sample comprised 50 individuals with stroke and 50 individuals without disease, for 80% power with a 5% type 1 error. The Modified Occupational Questionnaire was administered to assess the temporal activity pattern. Individuals identified the activities performed at each hour of the day and data was analyzed. Results The temporal activity pattern of individuals with stroke differed from healthy controls; education and play activities were not part of stroke participants’ daily routines. Also, participation in work, leisure and social participation activities was significantly different for people with stroke compared to healthy controls ( p < 0.01 ). The study group assigned very low values to the activities; the value perceived by individuals differed significantly between groups ( p < 0.01 ). Conclusion Clinicians are in a position to enable individuals’ time use and help to engage them in meaningful activity. Individuals with stroke may benefit from a program focusing on the temporal aspect of activities.
... The activities of all people are performed in contexts in relation to time and have a relationship to health, as illustrated in occupational therapy theories [28]. The approach Time Geography is applicable in many research topics and is described as an interdisciplinary field, though it originated in human geography [29]. ...
Article
Background: Little is known about the everyday life of individuals with Rett syndrome. Aim/Objective: To describe ten participants’ (teenagers/young adults) activities during a period of seven days, the time-use, where and with whom the activities were performed and the participants’ responses in the form of visible/audible reactions during activities. Material and method: A time-geographic self-administered diary was filled in by 63 informants (parents/support staff) and analysed using the software, DAILY LIFE 2011. Results/Findings: The most frequently reported activities were hygiene/toilet, moving around indoors, eating and getting dressed. Most time was spent in sleeping, daily care, medical health care and travel/transportation. Little time remained for receptive activities, daytime rest, physical, social/creative, communication, school/daily work and domestic chore activities, especially for the young adults. Most time was spent with staff, thereafter with families and the least time was spent with friends. The most reported response was “interested”, and “opposed” was the least reported. Conclusions: Daily and medical health care activities were time consuming. Improved communication between all parties may increase participation and well-being and provide solutions for handling unpleasant activities and sedentary time. Significance: A more varied range of activities may improve the everyday life for individuals with Rett syndrome.
... In Occupational Therapy, although time is a dimension considered to prepare and manage activities, there are few studies that put it as a central axis of investigation. In some countries in Europe and in countries such as Canada, the USA and Australia, Occupational Therapy already uses time as an important dimension in the comprehension of the nature and quality of people's life 12,[23][24][25][26] . ...
... At EMBRAER, what people did and the time spent with their day-to-day activities showed signs of directly influencing their quality of life. Since then, I have deepened my knowledge and developed research focused on the relationship between occupation and the use of time (STINSON, 1999;EMMEL et al., 2002;FARNWORTH, 2003;ZEMKE, 2004;PEMBERTON;COX, 2011;NUNES et al., 2013;LOURENÇO;EMMEL, 2016). ...
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This essay reflects the paths I have taken in occupational therapy during 40+ years in this profession, presenting briefly the main important activities and participation of my career. It is possible to visualize the route followed in the choices of research issues and the beginning of a series of projects and directions to growth and recognition of the Brazilian occupational therapy. The participation with the research funding grants and the strengthening of research activities are presented. Recounts the history of the foundation of the Occupational Therapy Program at Universidade Federal de São Carlos (UFSCar), the first research laboratory in Occupational Therapy in Brazil, the Journal of Occupational Therapy - UFSCar and also the Postgraduate Program in Occupational Therapy UFSCar (PPGTO). Some of the main challenges faced in teaching, community activities, the university management and the production of knowledge in occupational therapy are still registered, which contributed to the development of the profession.
... Waiting was described as a low stimulus occupation; however, the perception of the waiting experience is determined by what a person does to fill up the space (Larson, 2004). Engaging in meaningful activities can therefore result in a positive experience of waiting and can shorten the perceived time spent (Larson, 2004;Pemberton and Cox, 2011). In this study, family members described the challenges of engaging in meaningful activities while waiting. ...
Article
Introduction Caregiving associated with driving disruption following an acquired brain injury is challenging and impacts on family members' daily lives. However, little is known about the activities and meaning behind the occupation of a family member providing care during driving disruption. Method A prospective longitudinal design with a phenomenological approach was used as part of a larger study exploring family members' needs and experiences. Forty-two semi-structured interviews were conducted with 15 family members over a 6-month period. Interviews were analysed using inductive thematic analysis. Results The occupational experiences related to caregiving during driving disruption emerged as a key finding. The meaning and activities comprising the caregiving occupation during driving disruption are captured in three themes: (1) More than just driving; (2) The invisible and undervalued care and (3) Being a therapist at home. Family members highlighted the challenges of managing broader and multiple responsibilities. Conclusion The lived experiences, perceived meaning and activities involved in the caregiver occupation during driving disruption extend beyond just transport provision. Family members require support for occupational engagement and satisfaction at this key time. Rehabilitation and support for the person after an acquired brain injury may also improve the occupational experiences of family members.
... These building blocks are important to understand older adults' organization of their PDO. These findings contribute to the understanding of ''occupation itself'' defined by their temporal aspects, as proposed by Hocking (2009), and that those aspects need to be further explored (Pemberton & Cox, 2011). ...
Article
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This study sought to expand knowledge regarding patterns of daily occupations and, specifically, to explore and describe the daily occupations of Swedish people aged over 70 years by investigating sequences, contexts and time-use. A cross-sectional design with a time-geographic approach was used. Open time diaries from 151 participants were collected and analysed using the software VISUAL-TimePAcTS. The results were illustrated as a routine of six pooled intervals during 24-hour sequences. The intervals comprised different lengths of time and each interval was dominated by different occupations. Night was dominated by ‘care for oneself’; morning by ‘house-keeping’ and ‘reflection and recreation’; lunch-time by care for oneself; afternoon by ‘reflection and recreation’; dinner/tea-time by ‘care for oneself’, and evening by ‘reflection and recreation’. The results were also illustrated as characteristic profiles of occupations visualised by the number of participants in each occupation during 24-hour sequences. Occupations were mainly supported by the home environment. Summed time-use showed the highest proportions in ‘care for oneself’ and ‘reflection and recreation’ occupations. To what extent health and well-being experiences of patterns of daily occupations might be related to challenges and fulfilment of basic occupational needs requires further investigation.
... Several authors have emphasised the importance of the temporal organisation of occupations into patterns of everyday life (Farnworth, 2003;Hocking, 2009;Hunt & McKay, 2012;Larson & Zemke, 2003;Pemberton & Cox, 2011). However, there is no unanimous concept or term for defining the organisation of everyday occupations or their contribution to health (Bendixen et al., 2006;Bjö rklund, Gard, Lilja & Erlandsson, 2013). ...
Article
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The aim of this study was to identify characteristics of temporal patterns of daily occupations that could be related to high and low subjective health among older adults in Northern Sweden. A cross-sectional design imprinted by time-geographic methodology was used and participants 70 years and older were purposively selected and divided into groups of high and low health using the SoC-29 and SF-36 questionnaires. Daily occupations data were registered and analysed using VISUAL Time-PAcTS and related to health conditions using SPSS. The results showed that the participants in the high- and low-health groups showed similar patterns of participation in occupations during the 24-hour sequences describing their daily routines. Some differences in patterns of frequency and duration of occupations were shown between health groups during the 24-hour sequences as well as within six intervals. The low-health group showed higher frequencies and longer durations for “care for oneself” and “reflection and recreation” occupations and lower for “house-keeping” and “procure and prepare food” occupations compared to the high-health groups. There were few significant differences between the high- and low-health groups' mean durations for occupations. The results of this study could contribute to the support and assistance of occupations of older adults in society.
... The area of "Occupation" (see Figure 1) is conceptualized as meaningful, everyday human activity that happens in a particular time and place, by which humans sustain their livelihoods within a given context (22,23,33,35) and that can be named in the cultural lexicon (36). Everyday activities are configured differently according to time and place (37,38). An understanding of occupation is contingent upon the interplay of the dimensions of its meaning, namely: doing, being, becoming, belonging, and knowing (39). ...
Article
Objective: This study focuses on the design of an entry-level educational model of culturally responsive care in occupational therapy embedded in service-learning (CRCOT-SL) that is perceived as clear, relevant, evidence-based, and useful by occupational therapy educators. The purpose of the model is to guide OT educators in teaching students to enable occupational participation and social inclusion in cross-cultural encounters. Method: The design consisted in defining the areas of the model and the components of each area, and articulating the learning process embedded in service-learning. A formative evaluation of CRCOT-SL was then performed using survey methods to collect feedback from 30 OT educators regarding the clarity, relevance, evidence-based constructs, and usefulness of CRCOT-SL. Results: CRCOT-SL was perceived to be clear, relevant, evidence-based, and useful to 81.5% of the OT educators who participated in the study. Minor modifications to the model were completed based on the educator's feedback. Conclusions: CRCOT-SL is intended to respond not only to the dynamic, multicultural, and diverse environments in which practitioners currently practice but to the future needs of a global community facing social, political, economic, and environmental issues that will continue to affect dramatically people's living conditions and occupational needs.
... In 2003, Farnworth asked whether time use was occupational therapy's core business or someone else's, and more recently Pemberton and Cox (2011) have asked 'What happened to the time?' A conference hosted by the International Association of Time Use Research at the University of Oxford gave the opportunity to reflect on these questions. ...
Article
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Time use is of enduring interest to occupational therapists and occupational scientists. However, occupational researchers have yet to exploit fully the potential of large population-level time use datasets. A brief overview of the historical development and current activities within time use research internationally is presented. Whilst acknowledging the challenging nature of this type of research, the authors explore some of the opportunities offered by the secondary analysis of large time use datasets for occupational therapy and occupational science researchers who seek to advance knowledge of human activity, participation and health.
... In 2003, Farnworth asked whether time use was occupational therapy's core business or someone else's, and more recently Pemberton and Cox (2011) have asked 'What happened to the time?' A conference hosted by the International Association of Time Use Research at the University of Oxford gave the opportunity to reflect on these questions. ...
Article
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... Time spent on different activities has also been the focus for occupational balance, e.g. the fifth dimension in the Model of Lifestyle Balance (4) is about organization of time (and energy). The complexity of time, though, and its relevance for occupational therapists has recently been highlighted in a review (32). ...
Article
Life balance seems subjective, health related, and multidimensional. However, the concept is complex. Exploring what people themselves consider more or less important for their life balance and whether this differs between people would develop new knowledge. Q methodology was chosen for the present study, in which 32 working men and women without recent long-term sick leave participated. They sorted 42 statements regarding life balance according to their importance for each participant's life balance. The analysis resulted in four different viewpoints concerning life balance. All four viewpoints considered good relationships with those closest to them, as well as knowing that these people were doing well, as important. Each viewpoint also showed a unique orientation towards what was considered important for life balance: occupational balance (viewpoint 1), self-actualization (viewpoint 2), self-awareness (viewpoint 3), and reciprocal relationships (viewpoint 4). The results. showed support for life balance as being a subjective, multidimensional, and health-related phenomenon. The results demonstrated the importance of relationships for life balance and heterogeneity in what people considered important for their own life balance.
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The perceived stress of time‐pressures related to modern life in Western nations has heightened public interest in how lifestyles can be balanced. Conditions of apparent imbalance, such as workaholism, burnout, insomnia, obesity and circadian desynchronosis, are ubiquitous and have been linked to adverse health consequences. Despite this, little research has been devoted to the study of healthy lifestyle patterns. This paper traces the concept of lifestyle balance from early history, continuing with the mental hygiene movement of the early twentieth century, and extending to the present. Relevant threads of theory and research pertaining to time use, psychological need satisfaction, role‐balance, and the rhythm and timing of activities are summarized and critiqued. The paper identifies research opportunities for occupational scientists and occupational therapists, and proposes that future studies connect existing research across a common link—the identification of occupational patterns that reduce stress. The importance of such studies to guide health promotion, disease prevention and social policy decisions necessary for population health in the 21st century is emphasized.
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This article highlights a time-geographic approach to understanding the temporal patterns of people's occupations and their relationship to health and illness. It outlines the use of diaries to gather data and proposes that this method makes it possible to study the everyday life context of individuals, capturing i) Activity contexts (everyday context and project context) ii) Geographic context iii) Social context and iv) Experiential context. The method has been used to gather information about activity patterns in everyday life, and further developed to identify health risks in a population and as a foundation for intervention in rehabilitation. Examples described are application of the method to promote change processes in a workplace and in a rehabilitation setting.
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This study builds on previous research that has aimed to clarify uncertainties regarding what happens before, during and after a ‘flow’ experience, a psychological state that appears to arise during optimal human experience. A phenomenological approach was taken to examine the flow experiences of seven participants. The method included participants keeping journals and semi‐structured interviews. The flow process seemed to vary between challenge‐skills, enjoyment, positive distraction and mindfulness experiences. These experiences had similarities, as all participants described them as positive psychological states that were a consequence of being absorbed in an occupation, but differed in relation to prior affect and the degree of challenge an occupation presented. This research has highlighted the importance of meaning and the essential role occupation may have in protecting well‐being. Occupations may lead to optimal experience when they lead to altered and ordered states of consciousness.
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It has been proposed that it should be possible to identify patterns of daily occupations that promote health or cause illness. This study aimed to develop and to evaluate.a process for analysing and characterising subjectively perceived patterns of daily occupations, by describing patterns as consisting of main, hidden, and unexpected occupations. Yesterday diaries describing one day of 100 working married mothers were collected through interviews. The diaries were transformed into time‐and‐occupation graphs. An analysis based on visual interpretation of the patterns was performed. The graphs were grouped into the categories low, medium, or high complexity. In order to identify similarities the graphs were then compared both pair‐wise and group‐wise. Finally, the complexity and similarities perspectives were integrated, identifying the most typical patterns of daily occupations representing low, medium, and high complexity. Visual differences in complexity were evident. In order to validate the Recognition of Similarities (ROS) process developed, a measure expressing the probability of change was computed. This probability was found to differ statistically significantly between the three groups, supporting the validity of the ROS process.
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Global health through occupation is contingent upon our understanding of the human as an occupational being. In this paper, I reflect upon two aspects of the human as an occupational being: 1) the biological need for occupation, and 2) tempo and temporality as a way of beginning to generate a blueprint for global health.Wilcock's theory on the human need for occupation proposes that people living in post industrial nations are diverted from engagement in occupations that function to meet biological needs. The theory largely addresses the issue of what kinds of occupations are likely to be health promoting, given a set of assumptions about the history of humans as occupational beings. On the surface it would appear that occupations that resemble those of prehistoric men and women would be optimal for promoting health and well‐being, but these kinds of occupations are largely unsuitable for incorporation into contemporary lifestyles. Yet, there are elements of prehistoric occupations that can be recaptured in contemporary activity, and I speculate on the form such occupation might take as a way of addressing the general question of what kinds of occupations are likely to be health promoting.The beginning blueprint for global health through occupation must also take into account the nature of occupational beings in relation to tempo and temporality. I argue that there is an intersection between tempo and temporality. The tempo of occupation is simply defined as its pace and rhythm. Temporality, in contrast, has to do with how we understand occupation in relation to past, present, and future events. When life is rushed as it is in the fast lane of modernity, the result can be the forgetting‐of‐being, or stated otherwise, doing without being. I suggest that healthier people and a healthier world could result from a blueprint generated through occupational science research that identifies the patterns of occupation that are likely to be maximally health promoting and the pace at which they should be undertaken.
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As the proportion of elderly people in the Australian population is rapidly increasing, especially the relative proportions of people over the age of 85, our society is faced with the challenge of planning and providing health and welfare services that meet the needs of the elderly. This exploratory study aimed to examine how a sample of elderly people spent their time, and the portion of that time that was spent in valued occupations. Relationships between engagement in valued occupations and life satisfaction were explored. Data were collected by subjects recording every occupation they engaged in over two days, recording the percentage of time spent in valued occupations and completing a life satisfaction scale. Fifty‐eight subjects living independently in the community were enrolled in the study by a random doorknocking procedure. All subjects spent some time in sleep, personal care and passive leisure. The hypothesis that as time spent in valued occupations increased, life satisfaction scores would increase, was not supported. Life satisfaction was not correlated with any occupation category. Gender differences were found in engagement in occupations and in the amount of time spent alone.
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The concept of lifestyle balance seems to have widespread acceptance in the popular press. The notion that certain lifestyle configurations might lend to better health, higher levels of life satisfaction and general well‐being is readily endorsed. However, the concept has not been given significant attention in the social and behavioral sciences literature and, as a result, lacks empirical support, and an agreed upon definition. This article presents a proposed model of lifestyle balance based on a synthesis of related research, asserting that balance is a perceived congruence between desired and actual patterns of occupation across five proposed need‐based occupational dimensions seen as necessary for wellbeing. It is asserted that the extent to which people find congruence and sustainability in these patterns of occupation that meet biological and psychological needs within their unique environments can lead to reduced stress, improved health, and greater life satisfaction.
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A primary assumption underlying occupational therapy intervention is that peoples’ use of time, or their participation in activities, is related to their overall well-being and quality of life. However, the translation of this assumption into occupational therapy practice often is not only invisible, but it is becoming increasingly difficult to sustain in current health care practices. This paper outlines current research and literature related to relationships between peoples’ time use, tempo and temporality, and their well-being, and will discuss implications for occupational therapy theory, practice and research.
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This paper discusses the ethics underlying the occupational repertoire of the post‐industrial citizen, giving attention to lifestyle phenomena such as increased tempo and quantity of occupations; manipulation of time, organisms and environments; decreases in sleep, rest and play etc. In trying to understand human behavior in the 21st century, an ethical perspective is delineated and some starting points for a discussion of ethics from an everyday occupational perspective are investigated. Using examples from contemporary Western society, human occupational behavior is described as imprinted by machine‐ethical values. It is argued that since behavior arising from such values has been little formulated or observed, it constitutes a substantial risk factor for ill health and stress. An alternative eco‐ethical perspective of occupation, inspired by Skolimowski the Polish professor of eco‐philosophy, is proposed. The concept of “ecopation” is introduced as an optional choice denoting occupations that are performed with concern for the ecological context at a pace that gives room for reflection and experience of meaning. The questions raised in this paper may be important for occupational scientists to more fully understand the implicit guidelines of contemporary and future occupation and for occupational therapists taking an active part in future healthcare.
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This review synthesizes occupational science, psychology, and sociology research and theory to describe how social interaction within daily rounds of occupations may be organized within the stream of time. The coordination and orchestration of activities between individuals is a highly sophisticated process that is proposed to rely on entrainment between members, shared background expectancies that promote orderly interactions within daily routines and mutually accepted beliefs about time. This article begins by describing the roots of the ideation and patterning of temporal socialization which is drawn from biological rhythms, values and beliefs, work and social commitments, cultural beliefs and engagement in activity. Next it introduces the key concept of occupatio-temporality or how occupation itself patterns participation through the rhythm, tempo, sequence, synchronization, requirement for personal resources, and compatibility with other occupations. Finally, examples from research studies illustrate the complexity of social coordination of activities within work and home settings, including the construction of temporal synchronicity for co-workers and families.
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Recent outcome studies have found that a significant number of people have limited opportunity for meaningful occupation following severe traumatic brain injury (TBI). The aim of this study was to compare the time use of 37 people more than three years post injury with time use in the general Australian population. This time use study was part of a broader research project, which examined community integration and factors that lead to successful community integration. The results of this study were that the TBI sample spent less time in employment related activities and more time on personal care than the general population. They also spent more time alone and less time with family. The TBI sample spent as much time in the community as their peers, however they were less involved in shared occupation. Although this group of people had received comprehensive rehabilitation services following their injury, they experienced decreased opportunities for meaningful occupation and changes in social contact several years post injury. Comparisons of the sample with people who are not employed suggest that unemployment is only one of the factors that contribute to the under‐occupation of people with TBI. The time use data collected provides a window on lifestyle changes and indicates that severe TBI has a significant negative impact on people's level of participation and well‐being.
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Experience sampling examined how temporality, the lived experience of time, varied related to specific activity qualities and experiences in everyday life. Thirty-five students completed electronic surveys regarding their current activity and feelings and rated the activity's novelty and complexity, their depth of emotional and intellectual engagement, the direction and depth of attention, and the demands of the activity on their skills. Using configural frequency analysis and an analysis of narrative responses, configurations of factors (types) associated with variations in perceived temporalities were described. Four composite types identified occurred with any temporality. In most habitual activities, time was perceived as passing the same as clock time. Most faster or timeless temporalities occurred in complex, novel, and skill-requiring activities that engaged participants. Unexpected activity configurations were also associated with accelerated perceptions of time. Occupational therapists may use this knowledge to assist clients to redesign activities that promote positive experiences without high activity demands.
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What constitutes enjoyment of life? Optimal Experience offers a comprehensive survey of theoretical and empirical investigations of the 'flow' experience, a desirable or optimal state of consciousness that enhances a person's psychic state. The authors show the diverse contexts and circumstances in which flow is reported in different cultures, and describe its positive emotional impacts. They reflect on ways in which the ability to experience flow affects work satisfaction, academic success, and the overall quality of life
How persons with dementia may experience time, temporal problems and temporal adaptations in their everyday lives is explored. The clinical implementation process and outcome of time aid interventions in five cases are also described. Data were collected through initial interviews with five participants, diagnosed with dementia, and with three spouses. Thereafter, time aids were chosen for intervention in each case. During the intervention, data were collected through fieldnotes and interviews, including evaluative interviews closing the interventions. The participants described experiences of temporal rhythms and extensions. Their temporal problems mainly concerned temporal relationships and coherence, and "knowing when" and "how long". They individually met the problems with strategies that aimed to overall decrease the effects of the temporal problems in general, as well as with direct and conscious attempts to address problems mainly concerning temporal orientation. When time aids were used, difficulty "knowing when" seemed to be most responsive to aids. However, the success of the time aid interventions was limited, as was the success of the spontaneously used strategies. Motivation and insight seemed to be important, as well as the participants' present and former attitudes to temporality. Possible implications for occupational therapy interventions are discussed, considering the clinical and piloting nature of the study.
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Our daily round of occupations occurs within time and space. Our understanding of occupation has traditionally viewed time and space as part of the external environment. Patterns of the "when?" and "where?" of occupations can be described. But relating time and space to the internal experience of occupation reflects more of the meaning to individuals and more complex patterns arise. Like the varied bits of glass in the object case of an art kaleidoscope, the multiple elements of occupation interact. Reflected in mirrors of our choice, we find always-changing, complex patterns of daily occupation. The elements of occupation most important for maintaining or regaining health and the mirrors and lens through which we view occupation historically have formed shifting patterns in occupational therapy, patterns of how we view ourselves, our practice, and those to whom we provide our services. We must combine the science and the art of occupational therapy as the metaphor of the kaleidoscope combines both, producing awe and wonder at the result.
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The article examines relationships between the use of time, subjectively perceived time pressure, life stress, mental health, and life satisfaction from a life cycle perspective, using data collected as part of the 1986 and 1992 Canadian General Social Surveys, and the 1994 Canadian National Population Health Survey. Analyses reported in the article suggest that subjective sense of time pressure is grounded in objective reality. Respondents and life cycle groups reporting higher levels of perceived time pressure carry heavier loads of paid and unpaid work, and are limited in their access to leisure time resources. Low as well as excessive levels of time pressure seem to correlate negatively with mental health. Life‐cycle situation strongly affects respondents’ sense of life satisfaction and emotional well‐being. Employed married respondents in the 25 to 44 group, and particularly the 45 to 64 age group, with or without children at home, report the highest levels of emotional well being, in spite of the fact that some of these groups are pressed for time. The lowest levels of life satisfaction are reported by the unemployed, students, and divorcees. The article testifies to the fruitfulness of Wilensky's (1981) attempt to tie the analysis of perceived quality of life to life course progression, stress, and access to time.
Article
I examine the interactive processes by which women and men negotiate family time schedules. Based on fifty interviews with seventeen dual-earner couples, I focus on the ways men and women define time in gendered ways, exert different controls over the way time is used, and align their time strategies in the course of managing everyday family life. The results indicate that there are both continuities and discontinuities with the past: women continue to exert more control over the organization of time in families, but time negotiation itself has become a more complex and demanding activity. The way that couples carry out these negotiations reflects a variety of adaptive strategies, with some couples being very reactive in contending with present demands and others being highly structured and seeking to anticipate and control the future. Although some couples worked to negotiate balance in their time responsibilities, it was wives who maintained control over time and, ultimately, the orchestration of family activity.
Article
Research investigating occupational experience among people with mental illness has highlighted their difficulties in selecting, organising, valuing, enjoying and competently performing occupations. Although occupational therapy literature consistently identifies environmental factors as key in facilitating successful and valued engagement, few authors have studied the implications of detention in secure mental health settings for this population. This study investigated the occupational experiences of five people with schizophrenia in two forensic regional secure units. Quantitative and qualitative methodologies were used, with semi-structured interviews adding depth and subjectivity to Occupational Questionnaire (Smith et al 1986) responses. The quantitative data were analysed using non-parametric analysis, with content analysis applied to the qualitative data. Time-use was characterised predominantly by engagement in passive leisure and rest occupations. This reflects the findings of both inpatient and community-based studies elsewhere and suggests that mental illness is a common factor influencing time-use. The participants chose occupations based on expectations of enjoyment and success, and associations with independence and normality. Significant correlations were found between perceived competence, value and enjoyment (p<0.01), and the participants were more likely to enjoy self-chosen occupations (p<0.05). Forensic occupational therapists must use evidence to optimise resources and deliver interventions that facilitate choice and autonomy and reflect individual needs. Further research with larger samples and longitudinal methodologies will facilitate generalisation and establish temporal perspectives.
Article
This phenomenological study describes the lived‐experience of night shift and the adaptive strategies used by night shift nurses. Eleven female night shift nurses working in the nursery and birthing centers of two affiliated Midwestern hospitals in the United States participated in the study. Face to face, semi‐structured individual interviews were conducted and data were analyzed using a qualitative approach to discover patterns and themes. Two themes emerged that reflected the lived experiences of the night shift nurses: (1) Living by night, sleeping by day: The masquerade, and (2) Relationships and family lives: A kaleidoscope. Two additional themes were identified to describe the adaptive strategies of the night shift nurses: (3) A ‘just do it’ attitude and (4) Occupational strategies for nightlife. Findings of the study suggest that the temporal challenges and demands of night shift disrupt occupational patterns and routines, which are strongly influenced by the diurnal nature of humans. Many of the night shift nurses made sacrifices in order to fulfill their life‐roles and re‐establish meaningful occupational routines. As they struggled to adjust, many also experienced feelings of guilt, as if they were wasting their day sleeping. The process of temporal adaptation to night shift is complex and continuous and affects all domains of the night shifter's life.
Article
The study of children's occupation is receiving more attention in the occupational science literature. This trend corresponds with a global interest on child health and well‐being. Research into the activity patterns of children in natural environments offers to advance knowledge about children's participation, health and occupational development. This study was conducted using time‐use methods to explore and identify activities and environments of Irish children aged between 5 and 8 years in 2007. Findings support the need for environmental contexts to be taken into account when considering occupational development. Further study of time‐use methods is warranted for use in examining the children‐environment–occupation relationship.
Article
My research on the time use and subjective experience of young offenders has uncovered that many experience a high degree of boredom. At first, this boredom appears to be related to their lack of engagement in productive occupations, such as education and work and the predominance of time spent in passive leisure and personal care occupations. The experience of boredom is often associated with ideas of victimization and entrapment. An implicit assumption is that people have a right to not be bored, and that society's obligations include preventing this boredom. One means to achieve this is believed to be through engagement in paid employment. However, in this paper, I will argue that boredom may loom large in our culture today and may be just as prevalent amongst those in paid employment as those who are unemployed. Using my research with young offenders and several literary explanations of the phenomenon of boredom, I will illustrate that boredom is a little understood concept which is intimately linked with human occupation and meaning, and thus is of interest to occupational scientists.
Article
Indigenous time began with the Era of Creation. White time began with the invention of the calendar, sundial and clock. White time was, and still is, influenced by the calendar, clock or watch. Time to go to sleep, time to get up, time to go to work...go home, time for dinner and time to watch the football or cricket. Even time put aside for sex! Traditional time was not set by the calendar, sundial, clock or watch, but by events such as seasonal movements and other traditional practices, the resources, the environment and by us. White time has resulted in the decline of resources, family instability, the deterioration of the very air we breathe. Whose time is better...your time or my time?
Article
During this Third Australasian Occupational Science Symposium, some thought provoking presentations gave cause for reflection on some challenging occupational issues. These included the occupation/identity nexus and its relationship to happiness; the complexities of time perceptions and time use from historical, indigenous, gender related and demographic perspectives; the relationship between objects and occupations in a consumerist Western context; the impact that globalisation can have on discrete groups of people; and, how reconsideration of the ideals of community from the past can help us create environments that stimulate, rather than hinder, the realisation of occupational potential.
Article
Data used in this article were collected from 182 adults working for major blue‐collar and white‐collar employers in the Kitchener‐Waterloo area (Ontario, Canada) as part of the 1985 Experience Sampling Survey. This article discusses differences in daily lives and accompanying moods of employed population, as a function of gender and calendar week.The article addresses the following questions: (a)How does the weekly rhythm of daily and leisure activities vary by gender? (b) How do men's and women's motivations for engaging in daily activities vary across the week? (c) Do men's and women's experiential states vary across the week differently ? (d) How do the experiential states of men and women differ within the context of different daily activities? (e) How do the behavioral and experiential profiles of individual calendar days vary by gender?
Article
Previous time-use research suggests that it is highly relevant for an occupational therapist to estimate time use and occupational engagement in order to understand some of the determinants of wellbeing for people with schizophrenia. This article describes the development and the testing of the psychometric properties of an instrument, Profiles of Occupational Engagement in people with Schizophrenia (POES), with the aim of helping to interpret and evaluate time-use diaries and thus providing a systematic description of status regarding occupational engagement. The first part of POES involves completion of time-use diaries and the second part, the assessment, is based on nine items that are rated on a four-point ordinal scale. The time-use diaries of 41 people with schizophrenia and the judgements from 12 occupational therapists were used in the study. A test of content validation involved experts from Sweden and the United Kingdom and resulted in two stages of revisions. The strength of agreement between two raters resulted in a mean weighted kappa of 0.70. Internal consistency was calculated for both raters separately and the alpha coefficients were 0.97 and 0.95. This study provides initial support for the content validity, interrater agreement and internal consistency of POES. Based on the judgements of the occupational therapists in this study, POES seems to have good clinical utility. However, further research on the clinical utility as well as the criterion validity of the construct is warranted.
Article
This article discusses findings from a larger study about what it means to be a shift worker in regional Australia. Twenty seven shift workers including taxi drivers, sex workers, police officers, factory workers and truck drivers participated in order to provide a cross section of diverse occupational and social strata. Using Frank's concept of occupational adaptation, the shared adaptive strategies of these shift workers are explored. It is argued that their routines and rituals form a protective device for shift workers in their daily struggle to overcome both physical and social barriers to meaningful occupation. That the experiences and adaptational strategies of shift workers from such diverse occupational groups were similar reveals a high level of shared meaning.
Article
This study investigated time use and the importance of instrumental activities of daily living (IADL) tasks to an older community-dwelling population. In addition, the study compared occupational therapists’ and older people’s perception of importance of IADL tasks for maintaining community living. Thirty-three subjects completed a time diary and an interview-based questionnaire to ascertain their time use and the importance of IADL tasks. It was found that older people living in the community spent most of their time at home and alone, with nearly half the day being spent on IADL tasks. The subjects indicated that the three most important tasks were use of the telephone, use of transportation (including driving) and reading. Differences were found when the results from an earlier study of occupational therapists were compared with results from the present study of older people. The occupational therapists also considered use of the telephone as most important but then rated medication management and snack preparation as the most necessary activities for continued community living. These results emphasize the differences in the perception of ‘important’ between the two groups studied. The results from this research confirm the importance of IADL to both the occupational therapy profession and older people living at home in the community. Further, these results confirm the need for client-centred practice and collaborative intervention planning for occupational therapy.
Article
Objectives: Data on time use and role participation can provide rich information that can help occupational therapists better understand older people's lives. This study aimed to (i) describe the time use and role participation of community-dwelling people aged 65 years and older, (ii) analyse whether time use and role participation changed with increasing age, and (iii) determine if there is a link between maintenance of role participation and life satisfaction in older age. Methods: Using a cross-sectional design, interviews including the Activity Configuration, Role Checklist and Life Satisfaction Index-Z were used to collect data on 195 participants (mean age 75 years, 58.5% female). Results: Participants spent most of their time on sleep (8.4 h/day), solitary leisure (4.5 h/day), instrumental activities of daily living (3.1 h/day), social leisure (2.7 h/day) and basic activities of daily living (2.6 h/day). The most common roles were friend (96.4%), family member (95.4%) and home maintainer (87.2%). Participants aged 75 years and older spent significantly more time on solitary leisure and less time on paid work and transport compared to those aged 65–74 years. Role maintenance was significantly related to greater life satisfaction in participants aged 75–84 years. Conclusion: Older people's occupations and roles are diverse, and increasing age does not appear to reduce occupational or role engagement. The value of roles is not always reflected in the amount of time devoted to them and facilitating continued participation in valued roles may be important for older people's life satisfaction.
Article
This interpretive study of eight cognitively young older consumers explores how they perceive time, how they use their time, and how this affects their consumption activities. The authors review how time has been examined in consumer research and apply their findings to previous approaches to understanding time consumption. These cognitively young older consumers were found to be actively involved in the world, having a number of demands and obligations. They were still very much part of today's material world and had a strong future orientation.
Article
The concept of temporal adaptation was introduced into the field of occupational therapy early in its development; however, it has not been developed as part of the theoretical backing of the field. This paper re-introduces the theme and provides both a general prospective for the clinician in thinking about patients' temporal behavior and a preliminary framework for application. Temporal adaptation when applied in clinical practice should add a wider perspective to existing clinical interventions. It is proposed as a generically applicable theoretical perspective appropriate across all dysfunctional categories of patients. Two case histories are presented to demonstrate the application of the theoretical framework to intervention.
Article
American society's conceptualization of time as a commodity has supported occupational therapy practice since its inception. This article discusses numerous contemporary media messages about time both because they are pervasive and because their meaning often escapes us. Popular magazines, greeting cards, and cartoons weave themes about time into the fabric of other messages. There is remarkable coherence in the themes that cut across these three sources of time messages. Commercial images reveal the ideas that we are asked to accept about time; satirical images ask us to reflect about the ideas that we have accepted. A preponderance of images suggest that we control time and live in style. These suggestions constitute a cultural force that shapes personal values toward an end that we rarely consider. Occupational therapists need to recognize the presence and power of media images that radically challenge the meaning of living a satisfying life.
Article
This paper begins with a literature review to investigate temporal dysfunction and its relationship to psychopathology and to adaptation. A specific program begun in a short-term hospital with psychiatric patients is then described. This program uses temporal adaptation as a framework for assessing patients' use of time and for developing methods to increase productive use of time.
Article
This is the second in a series of four papers that discuss and present a model of human occupation. The first paper presented the structure and content of the model. This paper conceptualizes change according to the model. It introduces the systems concept of hierarchy into the model as a foundation for explaining its ontogenesis. Two facets of change are proposed. The first facet is a series of stages through which occupation is processed. The second is a description of ontogenesis through the life span from the perspective of temporal adaptation.
Article
The contribution of a balance of work and leisure to health and a sense of well-being is a common sense assumption in everyday knowledge as well as in occupational therapy. The impact of the organization and balance of occupations in daily life on health, adaptation, life satisfaction, and a sense of well-being are central issues in occupational science. One of occupational science's potential contributions to society is the ability to provide understanding and insights that transcend common sense assumptions and everyday knowledge about occupations. This article will address, through a review of the literature, some of the limitations inherent in beliefs about a healthy balance of work and leisure. It will demonstrate how distinctions between work and leisure are culturally bound and perpetuate the assumption that they are dichotomous experiences. This dichotomy is shown to be a false one and must be transcended in order to explore the question of what is a healthy balance within daily life. This article concludes with considerations for occupational therapy research and practice that may arise from transcendence of the dichotomy of work and leisure.
Article
At the close of the 20th century, there is a renaissance of occupation in occupational therapy and occupational science. Kielhofner (1992) offers an intraprofessional explanation that the growing interest in occupation recaptures occupational therapy's lost identity. An extraprofessional explanation is that postmodern ideas and social practices have helped to create a societal context in which a renaissance of occupation is welcome. Postmodernism raises questions and awareness of power, diversity, temporality, and situatedness in which normative ideas of occupation as paid work can be challenged. Since occupation is of primary concern to occupational therapy and occupational science, the authors reflect on postmodernism and its influence on a renaissance of occupation in these two fields. These reflections consider what such a renaissance means for occupational therapists and occupational scientists in the 21st century.
Article
Two forces are converging, creating conditions both challenging and potentially fruitful for occupational therapy. The profession’s knowledge base describing occupation is growing exponentially. At the same time, functional outcomes of intervention are being increasingly valued within the health care environment. Other professions imitate and claim our areas of expertise in the most flattering and dangerous ways. To benefit from the convergence of these forces, occupational therapy must expeditiously translate understanding of occupation into powerful occupation-based practice. Three bridges must be built: a generative discourse, demonstration sites, and effective education. The occupational design approach offers important conceptual tools with which to rapidly build these bridges to powerful practice. Described here are subjective and contextual dimensions of occupational experience, elements of the occupational design process, and how these factors produce therapeutic power through the appeal, intactness, and accuracy of interventions.
Article
Activity and occupation are two core concepts of occupational therapy that are in need of differentiation. Occupation is defined here as a person's personally constructed, one-time experience within a unique context. Activity is defined as a more general, culturally shared idea about a category of action. The ways in which subjectivity and context are handled within the concepts of occupation and activity are keys to disentangling them. The proposed untangling of the two concepts into distinct definitions is congruent with their historical origins as well as with current definitional trends. Once occupation and activity are recognized as two separate and equally valuable concepts, they offer a rich set of theoretical relations for exploration. The clarity that will result from differentiating occupation and activity will enhance disciplinary discourse and research as well as enhance the intervention efficacy, moral surety, and political strength of the profession.
Article
This experimental research study evaluated the impact of an 8-week psychosocial occupational therapy intervention program for mothers who have children with disabilities. Thirty-eight mothers of children with disabilities were randomly assigned to participate either in the treatment or the control group (19 in each). The occupational therapy intervention was designed to facilitate increased perceptions of satisfaction with time use and occupational performance, thereby positively affecting maternal and family well-being. The Canadian Occupational Performance Measure (COPM) was administered to measure self-perceptions of occupational performance and satisfaction over time. No significant differences were found between the two groups on time use perceptions. Although no significant differences were found between the two groups on the COPM Performance subscale, the treatment group demonstrated significantly greater score increases (p < .05) on the COPM Satisfaction subscale. This preliminary study suggests that attending to the time use and occupational concerns of mothers of children with disabilities can have a positive impact on their satisfaction with occupational performance.